Staying Safe: Medical Alerts & Emergency Alerts

First, a few general remarks. I didn’t write many posts last year, but I kept a lot of notes for future topics. A lot of those topics combine the knowledge I’ve gained and explored from the major aspects of my life: my cancer experience, my personal life, and my work life as a healthcare clinician. I like that. It makes me feel like I’m finally integrating the messy, fragmented existence I’ve led since I was diagnosed into some kind of whole. This post covers one of those topics.

Medical Alert Services: Communicating Your Medical Reality

Back when I was helping METAvivor publish their blog, I published a great post written by Susan, of The Uppity Cancer Patient called Medical Emergencies and the Single Girl. Lots of my homecare patients wear medical alert bracelets, but Susan’s post provides a lot of information about how to use this service in ways I did not then know about, but which I have since passed on to many people. Most of us probably regard these bracelets and necklace pendants as simply notifying emergency personnel that the wearer has diabetes or a significant medication allergy. But, as Susan found, that’s just the beginning of the story. It can also enable medical personnel “to quickly find my emergency contacts, talk to my doctor, find my living will, and receive an up-to-date list of all my medications and conditions.” In other words, the message engraved on the medallion is meant to be quick shorthand only, detailing the most crucial information when you cannot speak for yourself. But it also identifies a means by which clinicians and EMTs can rapidly find whatever information you decide they might need to provide you with appropriate care according to your wishes. A list of services is provided here, on the MedicAlert website: My MedicAlert Services

To initiate MedicAlert, one needs to purchase a bracelet or necklace. There are many more styles available than ever, and on Susan’s post, you can find links to other sources of more fashionable versions. Generally, an initial bracelet with a year of services can cost as little as $24.99, and after the first year, the services can be renewed for $19.99 a year. You can find complete information on the MedicAlert Foundation website, at MedicAlert.org.

Emergency Alert Services: When You’re At Home

“I’ve fallen and I can’t get up.” In homecare, this now-iconic phrase is no joke. Every year, up to a third of adults over age 65 will suffer a fall, for all kinds of reasons. And older people are not the only people who fall or find themselves having a sudden health crisis. “I think I might be having a stroke,” “I can’t breathe,” and “I think I’m having a heart attack” comprise many a health crisis. Many of the people having a health emergency will be at home alone at the time. Many of them will have a cellphone that is nowhere near them, and can’t be readily found when they most need it. When we admit a new patient to home health services, we provide them with printed information about personal emergency alert services. Basically, this is a service that provides a communicator that is hooked up to a landline phone, along with a button that you wear. If you are having a crisis, you press the button, which automatically communicates with a response center. They will respond immediately and try to talk to you though the communicator speaker to determine the nature of your crisis and initiate the emergency services you might need. But if you cannot respond, they will automatically initiate those services that you specify when you sign up, such as notifying emergency services and friends or family members who can come to assist you. Probably the best known provider of this service is Phillips Lifeline. Standard monthly services usually cost $30 per month, and an auto-alert service that is automatically triggered by a fall costs $45 per month. There may be discounts available for these services through local home health agencies or other elder service agencies.

Emergency Alert Services: No Matter Where You Are

Perhaps the most helpful advance in emergency alert services has been the variety of devices, apps and services now available for mobile alerts that can be activated wherever you are. Phillips offers a Response App for your smart phone for $13.95 per month which does not require a long-term contract. They also offer a service called GoSafe which provides alert services anywhere you are if you don’t have a smart phone.

One of the most interesting developments in this realm has been the development of ‘smart jewelry.’ An article by Charlie Stevens for PFSK, about Artemis Smart Jewelry, describes how one company is taking emergency alert services to another level. Marketed primarily to women of all ages, a company called Sense6 Design is working on a comprehensive emergency service called Artemis that they plan to have ready by the end of 2015. The service works with your smartphone by means of a clip or a pendant that you can tap in any kind of emergency — health, assault, fire or other kinds. The rechargeable communicator in the clip or pendant “uses a wireless connection with your smart phone to send an emergency transmission to our private security agency which is available 24/7.[…]The security operator uses live audio from your necklace, coupled with GPS data and your personal profile to determine whether to contact police, fire or medical staff to help you [and] simultaneously sends a text message to your choice of loved ones with your current location and a request for help.” The cost of a pendant starts at $49, and various emergency service plans cost from $1/month to text or email three friends, to $19/month for the full security service described above. By December, 2015, they plan to have this service fully functional for people who have an iPhone 4 or later, and by mid-2016 for those with Android smart phones. Further information can also be obtained at the main website for Artemis smart jewelry at Artemis by Sense 6 Design.

Other start-ups working on similar smart jewelry include Cuff and First Sign Technologies, summarized with Sense6 Design in this article in WearableWorldNews, published in February of 2014. Cuff is offering smart bracelets that will include Fitbit-style health and activity tracking and text/call notification, along with emergency notification.

First Sign Technologies offer a variety of products, including hairclips and pod devices attached to your keys, paired with services similar to to those offered by Smart6 Design’s Artemis products. Device options allow you to choose either an assault alert or a fall alert option, but apparently not both at once. First Sign’s services are geared primarily to providing personal security in the event of a violent crime, even detering attackers by emitting an alarm, collecting and storing audio and video evidence for police and responders, along with contacting emergency services. The security service that will work with one of their products costs as little as $5/month and works like that offered by Artemis, as a smart phone app that will operate with Apple iOS 4.3 or later and Google Android 2.1 or later. The communicator pod in your hairclip or keychain tag will contact a security operator who will be able to communicate with you, gather real-time information about your emergency, including your GPS location, and notify the appropriate responders. I could not find a clear target date on their site for when their full services will be on board, but the article posted on the WearableWorldNews site stated that First Sign was already well on their way to funding their services as of a year ago, and their site suggests that their services are operational now.

An Ounce of Prevention…

I have to admit to feeling like this is the most dire post I’ve written so far, and that it makes me want to get in bed with my cat and pull the covers over my head. However, as anyone who’s ever been diagnosed with cancer knows all too well, shit happens, and there’s nothing wrong with providing ourselves with some useful assistance in case more shit happens in the future. It may require us to wear a little more jewelry, but it’s a crazy world, my friends. Stay safe, okay?


Links:

Cuff
First Sign Technologies
Phillips Lifeline
MedicAlert.org
Medical Emergencies and the Single Girl
Sense6 Design’s Artemis Products

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I’m Still Here: My Year in Review

Six years ago today, I started this blog. So, first of all, thank you, dear readers and friends, for visiting, emailing, commenting, sharing, and generally making this labor of love worthwhile. You have definitely put the ‘social’ in social media. I’m glad I’m still here.

Things I Did in 2014

1. According to all my requisite tests, I remained free of cancer. Or, at least, whatever cancer can be detected by means of these tests. You never know. You do what you can.

2. I took what might be considered an embarrassing number of mostly cellphone pix of my cat Fiona. And why not? She’s eminently photogenic. There are, however, several other reasons for this. Not the least of them is that she’s my one remaining fur baby. Since I started this blog, which was shortly after finishing acute cancer treatment, I’ve lost four of the five fur babies I’ve had the pleasure of living with in the past six years. Three of the ones I’ve lost were cats, including the inimitable Chloe, a glamorous peach-point Himalayan; a silly, lovely black Persian male named Jett; and the incomparable Teddy, a gray and white Manx who was more popular among my Facebook friends than I was. The other fur baby I lost was my dog, Foxy. I miss them all. One of the things I noted from the start about being diagnosed with cancer is that, while it frightened me witless, wore me out, drained my bank account, and pissed me off, it didn’t break my heart. Losing my fur babies? That broke my heart.

And this past summer, for a few awful weeks, I was afraid I was going to lose Fiona, too. She developed hyperthyroidism, a not unusual health problem for older cats. But it snuck up on us so stealthily that, by the time her symptoms become obvious, she quickly developed other symptoms that are sometimes called a thyroid storm. Not only had she lost a significant amount of weight, but due to the stress on her system, she also exhibited cardiac and respiratory distress, and neurologic symptoms that manifested as seizures. She’s fine now, back to her normal fluffy self, everything behaving as it should, and taking her methimazole twice a day in her nutritious wet food. I may only have her for a few more years, but I want every minute of them that I can get. Hers is the face on my little web avatar, resting on my computer keyboard when I post comments on blogs, and I intend to keep her there as long as I can. So, in the meantime, she’ll just have to put up with my picture-taking.

3. I shredded about 38 cubic feet of paper, or the equivalent of about 20 good-sized cartons. It continues to mystify me, in this digital age, that I end up with so much paper, but there it is. Most of this accumulation was a direct result of being completely poleaxed by cancer treatment. Cancer-related fatigue is a subject about which I’ve posted many, many times, and has undoubtedly been for me the most life-altering aspect of cancer treatment. Needless to say, when about all I could manage for days and months and years on end, after dragging myself home from work, was to collapse into bed for a nap, scrape together some food for me and my pets, make sure I paid my bills, and keep the house from falling down, keeping up with the disposal of extraneous paper was very far down on my to-do list. So, it would get piled up, then stuffed into boxes or brown paper grocery bags, which would then get stuffed into whatever corner I could find, and summarily ignored. Until this year. There are still a few more cubic feet to go. But I’m on it now, and I have a lot more floor space. More room to dance.

4. I turned sixty. So did several friends, and a lot of other people, like Rene Russo and Denzel Washington, as well as writer Anne Lamott, with whom I share my date of birth. So far, it’s been pretty good being sixty. I may be slower, but I’m also a lot wilier.

5. I divested myself of a lot of stuff. Clothes, mismatched socks, tchotchkes, broken patio furniture, dead batteries, electronica. I recycled where I could, and the Big Sisters got a lot of donations. Maybe it’s something to do with getting older, but I’ve gotten to that point where I just feel like I have too much stuff. I’ve even made a pact with some of my friends about it. We now try to gift each other with experiences rather than things whenever possible.

6. I planted new plants in my garden. My long-term goal is to replace as much grass as possible with plants. Lawns are so overrated. It’s also nice just to have a long-term goal. For a few years there, I was afraid to make any goals at all. Perspective, baby. Buzz off, cancer.

7. I created a few memorable internet memes. The most successful of these was the Pinknado meme, which was created for a post that kicked off that hideous period of pink merchandizing excess known as Breast Cancer Awareness Month. I don’t know what officially constitutes having a meme go ‘viral,’ but I do know that my Pinknado poster was widely and satisfyingly shared over various social media. I can also report that it was printed, with my permission, to poster size and is hanging on the walls of a few like-minded souls. It was also featured in an article about cultural resistance to the Pink Peril by writer Gayle Sulik for the Breast Cancer Consortium. Among my favorites, it was even used, poster-sized, as part of a college sociology class, along with a showing of the documentary film, Pink Ribbons, Inc. This caused one of my friends to joke appreciatively, “Fantastic! ‘I received my Ph.D. in Pinknado.'” Perhaps the most promising news is that the folks who made Sharknado, whose movie poster inspired me, also released Sharknado 2 last year, with plans to release Sharknado 3 this summer. We could both keep this up for years to come.

8. I started writing a memoir. No, not about cancer. About my frequently crazy, sometimes magical, always challenging upbringing. It won’t be a linear thing, but a collection of stories and vignettes. I have a long list of them. I’ve shared a few here on the blog from time to time, so there will likely be more. Stay tuned.

9. I kept my sanity. Once you know the depth and breadth of #8, you’ll appreciate why this is an unparalleled achievement. Every day, in every way, I am thankful to be relatively sane.

10. I had the love and support of my friends. Without them, I’d surely be unable to accomplish #9. Real world and online, I was lucky enough to make new friends and deepen my relationship with old friends. I also lost a few dear friends in 2014, and I keep their memories in my heart. Surely the best thing I did this year was to be, I hope, a good friend to those I love. I don’t make resolutions, but I always resolve to be a good friend.

So, I didn’t go bungee jumping or skydiving, but when one works as a physical therapist, such activities lose their appeal anyway. I didn’t write as many blog posts as I’d like, but the mental rest has done me good, and I have lots of notes for upcoming posts. It was a year when I had to avoid listening to the news quite a lot. But I helped a lot of my patients. And I read dozens, if not hundreds, of books. And I had fun. And I laughed. And I found something for which to be grateful every day. It was a pretty good year. On to the new one. Hope you’ll all continue to be part of it.


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Stuff You Don’t Need: Medical Equipment Fraud

The graphic above links to an article by David A. Fahrenthold, published in The Washington Post a few months ago about a particular Medicare scam involving power wheelchairs that has gone on for years. Scammers made millions of dollars by employing the following strategies. First, they were able to get lists of stolen Medicare ID numbers or pay someone to round up patient names. Then, they were able to buy copies of doctors’ signatures or use the signatures of deceased doctors. They filed false claims for these chairs, because the profit margin was potentially huge. And they counted on the fact that Medicare cannot check every single one of the over four million claims it gets every day. The Justice Department has begun to prosecute these particular scammers, but there is always some other type of equipment or medical supply that scammers can use to file fake claims and make beaucoup bucks.

Recently, I became aware of yet another one of these apparent scams. I got a message from the doctor of one of my patients, asking me to provide a limb measurement for a splint so that the doctor could fill it in on the form she got, sign it, and send it off to complete the order. Thankfully, my employer has trained me well as far as patient documentation goes, and I’ve had a great deal of experience over the years filling out forms to justify the need for patients to obtain medical equipment. In this case, I knew, for example, that there was no diagnosis in the patient’s chart that related to this splint. You can’t buy supplies or equipment without a diagnosis that pertains, so I started by asking my patient about it. Neither my patient nor my patient’s family knew anything about any new diagnosis that would warrant a splint. But her family reported that my patient had lately received a number of phone calls offering ‘free’ medical equipment. After catching one of these callers in the act, they had concluded they had been made by telemarketing companies. Just to be thorough, I then assessed the limb in question, with ambiguous results.

Next, I called the doctor. Turns out that the order had not originated with her at all. She had received this order form at her office, which stated that the patient had requested the item to relieve a set of symptoms in this particular limb. The form bore the name of a generic, but plausible-sounding medical supply company and looked legitimate. I told her that the patient and the family knew nothing about this, and described the patient’s inconclusive symptoms. Finally, the doctor and I concluded that this was an attempt at fraud. The doctor also told me that their practice had received similar fraudulent orders before. She planned to report the company to Medicare.

The world is full of asshats, people, and they seem to have an endless supply of imagination when it comes to scamming our neighbors, our elderly parents, our disabled family members, or even ourselves, especially if we have experienced any significant health issues. Or even if we haven’t. Sometimes, all it takes is our phone number, and the illegally purloined knowledge of what insurance company we do business with, to be the potential victim of a fraud. A web search for fraud involving medical equipment and supplies yielded pages of results. Among them were these:

To fight back, here are a few links about how to recognize this crap and how to report it:

It’s also a good idea to make sure your phone numbers are current and listed with the National Do Not Call Registry. For more information about how the Registry works, and how to file a complaint, visit the Federal Trade Commission site.

Finally, you might want to talk to your doctors. And question everything. With a little less diligence, both I and the doctor I talked to this morning could have been hoodwinked into ordering something our patient didn’t need. The item in question is relatively small, commonly used, and doesn’t cost that much in the scheme of things. But if enough false claims were filed for this item by scammers, the profits could be considerable. And the doctor and I would have been unwittingly involved. It sure pays to be skeptical.


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“A Piece of Crap” — How I Met Tom & Ray Magliozzi

Ray & Tom Magliozzi

The Good News Garage

About thirty-two years ago, I decided I needed to find a reliable auto mechanic. I was still in my twenties, but I had finally gotten tired of relying on my dad and his local mechanics out in the ‘burbs to service my car. I was by then a card-carrying citizen of the city of Boston, in a neighborhood called Jamaica Plain. I worked across the Charles River in Cambridge, at MIT. Much of the time, I took the subway to work. Across the street from my apartment, I’d hop on the T at Forest Hills Station on the Orange Line, take it to Downtown Crossing, switch to the Red Line, ride to Kendall Square, and walk to 77 Massachusetts Avenue. There I would enter the huge, iconic main building of the MIT campus, and stroll down the infinite corridor to my first-floor office in the Department of Materials Science and Engineering, where I was a secretary to a small group of faculty members.

New England weather being what it is, however, I found myself driving to work more often. And when I drove, I listened to the radio, often tuning to WBUR, a radio station housed at the campus of my previous employer, Boston University, and one of the two NPR stations in the city. On Saturdays, WBUR broadcast this local, call-in radio show called Car Talk, moderated by a pair of MIT grads who were brothers and who happened to run a garage near their alma mater. Inevitably, my poor, tired old Toyota Corolla needed another oil change, and maybe a prayer or two, so I decided to take it to the Good News Garage and see if these dudes were as helpful in person as they were on the radio.

My first visit was straight-forward enough. I was greeted by Tom, who looked much as he did in the photo above, sort of an aging hippie type dressed in oil-stained work clothes. I knew from the show that he was a wise-ass. But though he took down my info with a certain wry efficiency, he was mostly all business that morning, and told me to come back after work, and to ask for Ray if he wasn’t there.

This was back in the early eighties, when my musical tastes ran to the Pretenders, the Clash, the Ramones, Elvis Costello, and some former, local RISD art students known as the Talking Heads. My hair was asymmetrical, clipped close to my head on one side, with a longish sweep on the other. I was known to wear a small, red, enameled safety pin in one ear. I was not known to wear tasteful business suits to work with sensible pumps. My MIT office was across the hall from a materials science facility identified as the “Creep Testing Laboratory,” the source of much sniggering humor among myself and the several graduate students who wandered into my office, looking for a professor.

While my car spent the day at the garage, I passed what was no doubt a typical eight hours, generally consisting of typing up arcane research reports or grant applications. Our department didn’t run to the new, dedicated word-processors that had recently come on the market, so I had to type on an IBM Correcting Selectric typewriter. Which was okay, except that I had to keep switching out the element ball to a Greek character one, so I could fill in the correct symbols for the calculus equations that were often liberally sprinkled throughout these documents. One of the professors wasn’t too careful about proofing his equations. Since I’d had a year of getting A’s in calculus in my thus-far unfinished college career, I used to correct them, thinking that I should get some kind of bonus for having such a skill, which was certainly not in my job description. Eventually, I wandered back to the Good News Garage to pick up my car. Tom wasn’t around, so I was greeted by Ray.

“Well,” he said, “we changed the oil. But you might want to think about getting a new car in the not-too-distant future.”

“Why? What’s wrong with it?” I asked.

Ray seemed to have to ponder this question carefully before answering. “Let me put it this way,” he finally said. “Your car is a piece of crap.”

It was only a car, after all, but still, my feelings were a little hurt. I swallowed, took a deep breath, and said, “Well, can you fix it?”

“We can probably keep it running for a while. But you are rapidly approaching that point where spending any significant cash on this thing will just be throwing good money after bad.”

“Shit,” I said. “I can’t afford a new car.”

“Where do you work?” he asked.

“At MIT.”

“Figures. Where do you live?”

“In Jamaica Plain.”

“Oh, good!” he said. “My advice is, take the T and start saving up.”

I drove home that day in a state of mild despair and not a little irritation at Ray’s bluntness. Still, I did let the Car Guys keep my car going for a while, but was ultimately forced to take their advice and junk the thing for a newer model. I also finally finished my bachelor’s degree, got a new job, and had to find a new mechanic closer to that job. I called the show a few years later, looking forward to reminding Ray of how he insulted my old car, and to reminding Tom that I spelled ‘Kathi’ with a ‘K’ and an ‘I.’ I got accepted into the call queue, but I didn’t end up getting on the air.

After that, I used to run into them occasionally. By then, their show had been picked up by NPR, which increased their celebrity status. They often served as MC’s for some of the local concerts and events I attended, like the fundraiser for the non-profit Passim’s Coffee House, held at the Somerville Theatre. The program featured several musicians who had played at Passim’s, including the then not-yet-famous Shawn Colvin, who played a poignant, acoustic version of a Talking Heads song that eventually made it onto one of her later albums. The song was called “This Must Be the Place,” but most of us just referred to it as “Home.”

Which brings me to a fitting way to end this remembrance. Tom and Ray may have come to be loved and enjoyed internationally once Car Talk made it onto the NPR program list, even earning a Peabody Award in 1992. But to us natives of metropolitan Boston or of Cambridge (“Our fair city,” as Ray & Tom called it), the Magliozzi Brothers have been always and ever our local boys. As MIT alums, their fame earned them an invitation to deliver the 1999 MIT commencement address. But long before that, they brought their sterling credentials and intelligence to a blue-collar profession that has come more and more to need the likes of MIT grads to do it properly. They came from an essentially urban, ethnic background, like so many of us, whose parents wanted us all to make something of ourselves. Their particular brand of smart-ass but affectionate humor is as familiar to us as Fenway Park, because our families had it, too. Consequently, listening to Tom’s laughter and errant silliness over the years has always been like coming home. Tommy, I know I speak for a lot of your original, long-time fans and friends when I say that we’ll miss you like a brother.
~
~
~
Tom Magliozzi died on Monday, November 3, 2014 at the age of 77 of complications related to Alzheimer’s disease.


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